EmailThe briefing paper, published on 16 December by the spending watchdog, says that wider changes will be needed across the health service if it is to save £15bn-£20bn in efficiency savings by 2014.
More for less 2009/10 criticises trusts that spend too much on certain services and recommends that they "reduce expenditure to that of their more efficient counterparts".
"In 2009-10, the NHS saw no identifiable changes in past trends. Acute and specialist trust income continued to grow at nearly 7% a year, with the most rapid growth in non-tariff areas. PCTs invested heavily in community services with a further 12% increase in 2009-10, following a 13% increase in 2008-09," says the document.
"But there was no nationally identifiable shift to providing more cost effective care outside hospitals – a crucial strand of the Quality Innovation Productivity and Prevention (QIPP) programme."
The commission published a similar analysis in 2009 and pointed out that many of the key markers of success in improving productivity from last year's paper "have remained virtually static". However, the document acknowledges that the NHS did make some improvements in some areas over the last year, and that some aspects of hospital efficiency improved.
The paper identifies a number areas where the health service could make substantial savings and suggests that:
- trusts could save over £200m annually by doing more day surgery;
- by reducing the cost of nursing per hospital bed to the average, trusts could save £300m, or £500m if they reduced to the performance of their most efficient peers;
- primary care trusts could make savings of £700m annually if those with more than the expected number of emergency admissions reduced to the average;
- hospital readmissions, which have risen by 7% in five years, and cost £1.5bn in 2009, could be reduced by introducing more effective public health strategies on smoking and alcohol.
The Audit Commission's managing director of health, Andy McKeon, said that although there was little sign of these changes beginning to happen in 2009-10, "the reassuring message is that there are still big savings to be made".
"The NHS has a daunting task ahead of it to cut costs by £15bn to 20bn by 2014 .The QIPP programme depends on the NHS reversing some long-standing trends of rising numbers of emergency admissions, improving hospital productivity and providing more care, more cost effectively, outside hospitals," he said.
"The underlying message is that those who commission NHS services need to find different, better, ways of meeting people's needs. All those who provide services need to cut costs."
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